JP2009525778A - Local control of inflammation - Google Patents

Local control of inflammation Download PDF

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JP2009525778A
JP2009525778A JP2008553437A JP2008553437A JP2009525778A JP 2009525778 A JP2009525778 A JP 2009525778A JP 2008553437 A JP2008553437 A JP 2008553437A JP 2008553437 A JP2008553437 A JP 2008553437A JP 2009525778 A JP2009525778 A JP 2009525778A
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factor
tissue
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トビー フライマン，
ウェンディ ネイマーク，
マリア パラシス，
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Boston Scientific Limited
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0073—Quadric-shaped
    • A61F2230/008—Quadric-shaped paraboloidal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body

Abstract

医療デバイスはキャリアと因子とを含む。因子は、心臓組織などの生物学的組織の炎症を制御するように処方され、解放可能にキャリアに結合される。キャリア（１３０）は、因子（１２０）によって治療されるべき生物学的組織に作用可能な近さに配置されるように構成される。一実施形態において、キャリアは、因子を解放するか、または生物学的組織に因子を送出するように構成され、そうして組織の炎症を制御する。また、生物学的組織の治癒を向上させる方法は、患者の心臓に近接して医療デバイスを設置することを含み、医療デバイスは、キャリアと炎症を制御するように構成される因子とを有し、因子は、解放可能にキャリアに結合される。一実施形態において、方法は、因子がキャリアから解放されることを可能にすることを含む。The medical device includes a carrier and factors. The agent is formulated to control inflammation of biological tissue such as heart tissue and is releasably bound to the carrier. The carrier (130) is configured to be placed in close proximity to act on the biological tissue to be treated by the factor (120). In one embodiment, the carrier is configured to release the factor or deliver the factor to biological tissue, thus controlling tissue inflammation. A method of improving biological tissue healing also includes placing a medical device proximate to a patient's heart, the medical device having a carrier and a factor configured to control inflammation. The factor is releasably bound to the carrier. In one embodiment, the method includes allowing the agent to be released from the carrier.

Description

（背景）
本発明は、概して、医療デバイスに関し、特に、心臓にまたは心臓の近くに設置されるように構成される医療デバイスに関する。本発明はまた、組織の治癒を向上させる方法に関する。 (background)
The present invention relates generally to medical devices, and more particularly to medical devices configured to be placed at or near the heart. The present invention also relates to a method for improving tissue healing.

炎症は、体の治癒の過程の自然の必要な一部である。しかしながらこの過程は、病理学的状態、損傷の状態、および疾患にさえも、さらに関連づけられている。心筋梗塞後に起こる自然の炎症過程は、既存の心筋のスカフォールド（ｓｃａｆｆｏｌｄ）の除去という結果になり、最終的には瘢痕形成−力学的および機能的に劣る組織という結果をもたらす。   Inflammation is a natural necessary part of the body's healing process. However, this process is further linked to pathological conditions, injury conditions, and even diseases. The natural inflammatory process that occurs after myocardial infarction results in the removal of existing myocardial scaffolds, ultimately resulting in scar formation-poor mechanical and functional tissue.

心臓組織または心臓を囲む生物学的組織の炎症を制御する全身療法は、心臓疾患の治療における見込みを示してきた。例えば、炎症が制御されると、より良い生物学的組織が形成され得る。しかしながら、そのような全身療法は、心臓の組織または心臓を囲む生物学的組織の炎症を局所的に制御しない。従って、心臓組織または心臓を囲む生物学的組織の炎症を局所的に制御するように構成されるデバイスに対するニーズがある。   Systemic therapy that controls inflammation of the heart tissue or the biological tissue surrounding the heart has shown promise in the treatment of heart disease. For example, better inflammation can be formed when inflammation is controlled. However, such systemic therapy does not locally control inflammation of the heart tissue or the biological tissue surrounding the heart. Accordingly, there is a need for devices that are configured to locally control inflammation of heart tissue or biological tissue surrounding the heart.

（概要）
医療デバイスは、キャリアおよび因子を含む。因子は、心臓組織などの生物学的組織の炎症を制御するように処方され、解放可能にキャリアに結合される。キャリアは、因子によって治療されるべき生物学的組織に作用可能な近さに配置されるように構成される。一実施形態において、キャリアは、因子を解放するか、さもなければ生物学的組織に因子を送達するように構成され、そうして組織の炎症を制御する。 (Overview)
The medical device includes a carrier and factors. The agent is formulated to control inflammation of biological tissue such as heart tissue and is releasably bound to the carrier. The carrier is configured to be placed in close proximity to act on the biological tissue to be treated by the factor. In one embodiment, the carrier is configured to release the factor or otherwise deliver the factor to the biological tissue, thus controlling tissue inflammation.

生物学的組織の治癒を向上させる方法は、患者の心臓に近接して医療デバイスを設置することを含み、医療デバイスは、キャリアと炎症を制御するように構成される因子とを有し、因子は、解放可能にキャリアに結合される。一実施形態において、方法は、因子がキャリアから解放されるようにすることを含む。   A method of improving biological tissue healing includes placing a medical device proximate to a patient's heart, the medical device having a carrier and an agent configured to control inflammation, the factor Is releasably coupled to the carrier. In one embodiment, the method includes causing the agent to be released from the carrier.

（詳細な説明）
図１に概略的に例示されるように、医療デバイス１００は、キャリア１３０に解放可能に結合される因子１２０を含む。キャリア１３０は、医療デバイス１００の設置時に因子１２０を保持するように構成される。因子１２０は、心臓組織などの生物学的組織の炎症を制御し、かつ／または減少させるように構成または処方される。用語「心臓組織」は、本明細書において、心臓組織、ならびに／または、心膜、心外膜、心筋、および心内膜を含むがそれらに限定されない、心臓を囲むかまたは心臓に近接する生物学的組織を意味するように用いられる。 (Detailed explanation)
As schematically illustrated in FIG. 1, the medical device 100 includes an agent 120 that is releasably coupled to a carrier 130. The carrier 130 is configured to hold the factor 120 when the medical device 100 is installed. The factor 120 is configured or formulated to control and / or reduce inflammation of biological tissue such as heart tissue. The term “cardiac tissue” as used herein refers to cardiac tissue and / or organisms surrounding or proximate to the heart, including but not limited to pericardium, epicardium, myocardium, and endocardium. Used to mean anatomical tissue.

キャリア１３０は、生物学的組織に作用可能な近さに配置されるように構成される。換言すると、キャリア１３０は、因子１２０が生物学的組織を治療し得るように生物学的組織に十分近くに配置されるように構成される。例えば、一実施形態において、キャリア１３０は、心臓組織に近接して設置または配置されるように構成される。   The carrier 130 is configured to be placed in close proximity to act on biological tissue. In other words, the carrier 130 is configured to be placed sufficiently close to the biological tissue so that the agent 120 can treat the biological tissue. For example, in one embodiment, the carrier 130 is configured to be placed or placed proximate to heart tissue.

一実施形態において、因子１２０は、既存の心筋のスカフォールドが心筋梗塞後除去されたり、または劣化したりしないように心臓組織の炎症を制御し、かつ／または減少させるように処方される。従って、そのような実施形態において、心臓組織中の瘢痕組織の形成は制御および／または減少される。   In one embodiment, the factor 120 is formulated to control and / or reduce inflammation of the heart tissue so that the existing myocardial scaffold is not removed or degraded after myocardial infarction. Thus, in such embodiments, the formation of scar tissue in the heart tissue is controlled and / or reduced.

一実施形態において、因子１２０は、医療デバイス１００が生物学的組織に近接して設置または配置された後に、キャリア１３０から解放されるように構成される。別の実施形態において、因子１２０は、制御される方法でキャリア１３０から解放されるように構成される。例えば、一実施形態において、因子１２０は、ある期間にわたり一定の速度でキャリア１２０から解放されるように構成される。別の実施形態において、因子１２０は、ある期間に第１の速度で、そして別の期間中に第２の速度でキャリア１３０から解放されるように構成される。   In one embodiment, the agent 120 is configured to be released from the carrier 130 after the medical device 100 is placed or placed in proximity to the biological tissue. In another embodiment, the factor 120 is configured to be released from the carrier 130 in a controlled manner. For example, in one embodiment, the factor 120 is configured to be released from the carrier 120 at a constant rate over a period of time. In another embodiment, the factor 120 is configured to be released from the carrier 130 at a first rate during a period and at a second rate during another period.

一実施形態において、因子１２０の特性は、因子１２０がキャリア１３０から解放されることを可能にする。例えば、そのような実施形態において、因子１２０は、キャリアに設置され、ある期間にわたり一定の速度でキャリア１３０から分解、溶解、または、分離するように構成されるコーティングである。別の実施形態において、キャリア１３０は、因子１２０を解放するように構成される。例えば、因子１２０は、キャリア１３０のウェル（ｗｅｌｌ）に配置される。キャリア１３０は、分解または溶解するように構成されるウェルカバーを含む。従って、ウェルカバーが分解または溶解するとき、因子１２０は患者に送達される。別の実施形態において、因子１２０はキャリア１３０内に配置される。キャリア１３０は、分解または溶解するように構成され、それによって因子１２０を患者に送達する。   In one embodiment, the characteristics of the factor 120 allow the factor 120 to be released from the carrier 130. For example, in such an embodiment, the agent 120 is a coating that is placed on the carrier and configured to degrade, dissolve, or separate from the carrier 130 at a constant rate over a period of time. In another embodiment, the carrier 130 is configured to release the factor 120. For example, the factor 120 is placed in a well of the carrier 130. The carrier 130 includes a well cover configured to degrade or dissolve. Thus, the factor 120 is delivered to the patient when the well cover degrades or dissolves. In another embodiment, the factor 120 is disposed within the carrier 130. The carrier 130 is configured to degrade or dissolve, thereby delivering the agent 120 to the patient.

因子１２０は、ＮＳＡＩＤ、ピラゾロン、フェナム酸、ジフルニサル、酢酸誘導体、プロピオン酸誘導体、オキシカム、メフェナム酸、ポンステール（Ｐｏｎｓｔｅｌ）、メクロフェナム酸塩、メクロメン（Ｍｅｃｌｏｍｅｎ）、フェニルブタゾン、ブタゾリジン（Ｂｕｔａｚｏｌｉｄｉｎ）、ジフルニサル、ドロビッド（Ｄｏｌｏｂｉｄ）、ジクロフェナク、ボルタレン、インドメタシン、インドシン（Ｉｎｄｏｃｉｎ）、スリンダク、クリノリル、エトドラク、ロジン（Ｌｏｄｉｎｅ）、ケトロラク、トラドール（Ｔｏｒａｄｏｌ）、ナブメトン、レラフェン（Ｒｅｌａｆｅｎ）、トルメチン、トレクチン、イブプロフェン、モトリン、フェノプロフェン、ナルフォン（Ｎａｌｆｏｎ）、フルビプロフェン、アンセイド（Ａｎｓａｉｄ）、カルプロフェン（ｃａｒｐｒｏｆｅｎ）、リマダイル（Ｒｉｍａｄｙｌ）、ケトプロフェン、オルヂス、ナプロキセン、アナプロックス（Ａｎａｐｒｏｘ）、ナプロシン（Ｎａｐｒｏｓｙｎ）、ピロキシカム、およびフェルデン（Ｆｅｌｄｅｎｅ）からなる群のうちの少なくとも１つを含む。別の実施形態において、因子１２０は、間葉幹細胞、徐放形態（ｔｉｍｅ ｒｅｌｅａｓｅｄ ｆｏｒｍ）のアスピリン、インターロイキン、ヘムオキシゲナーゼ、コルチコステロイド、タクロリムス、およびシクロスポリンからなる群のうちの少なくとも１つを含む。   Factor 120 is NSAID, pyrazolone, fenamic acid, diflunisal, acetic acid derivative, propionic acid derivative, oxicam, mefenamic acid, Ponster, meclofenamic acid salt, meclomen, phenylbutazone, butazolidin, diflunisal, Dorobid, diclofenac, voltaren, indomethacin, indocin, sulindac, clinolyl, etodolac, rosin, ketorolac, toradol, nabumetone, relafen, tolmetine, trectin, ibuprofen, tobuprofen Profen, Nalphon, Fulbiprofen, Ansaid Carprofen (carprofen), Rimadairu (Rimadyl), including ketoprofen, Orudjisu, naproxen, Ana PROX (Anaprox), naprosyn (Naprosyn), piroxicam, and Verden at least one of the group consisting of (Feldene). In another embodiment, the factor 120 comprises at least one of the group consisting of mesenchymal stem cells, time-released form of aspirin, interleukin, heme oxygenase, corticosteroid, tacrolimus, and cyclosporine. .

図２ａは、本発明の別の実施形態に従う医療デバイス２００の斜視図である。医療デバイス２００は、キャリア２４５およびキャリア２４５に解放可能に結合される因子２４０を含む。   FIG. 2a is a perspective view of a medical device 200 according to another embodiment of the present invention. The medical device 200 includes a carrier 245 and an agent 240 that is releasably coupled to the carrier 245.

この実施形態において、キャリア２４５は、ステントなどの管状の部材である。キャリア２４５は、第１の端部２１０および第２の端部２２０を有する。キャリア２４５は、第１の端部２１０から第２の端部２２０まで延びる空洞２３０を規定する。因子２４０は、図２ｂに示されるように、キャリア２４５の外側表面に解放可能に結合されるコーティングの形態である。   In this embodiment, the carrier 245 is a tubular member such as a stent. The carrier 245 has a first end 210 and a second end 220. The carrier 245 defines a cavity 230 that extends from the first end 210 to the second end 220. Factor 240 is in the form of a coating that is releasably bonded to the outer surface of carrier 245, as shown in FIG. 2b.

因子２４０は、浸漬処理または噴霧処理などの任意の公知の方法によってキャリア２４５の表面に配置されるか、またはさもなければ、解放可能に結合され得る。例えば、２００３年５月２７日に発行の名称「Ｓｔｅｎｔ Ｃｏａｔｉｎｇ」の米国特許第６，５６９，１９５号を参照されたい。該特許の全体は本明細書に参考として援用される。   Agent 240 can be placed on the surface of carrier 245 by any known method, such as dipping or spraying, or otherwise releasably coupled. See, for example, US Pat. No. 6,569,195 issued May 27, 2003, under the name “Stent Coating”. The entire patent is hereby incorporated by reference.

図２ｃは、本発明の別の実施形態に従う医療デバイス２０２の断面図である。医療デバイス２０２は、管状のキャリア２５５と因子２５０とを含む。例示されるように、因子２５０は、キャリア２５５の内側表面に解放可能に結合されるコーティングである。   FIG. 2c is a cross-sectional view of a medical device 202 according to another embodiment of the present invention. The medical device 202 includes a tubular carrier 255 and an agent 250. As illustrated, the factor 250 is a coating that is releasably bonded to the inner surface of the carrier 255.

図３ａは、本発明の別の実施形態に従う医療デバイス３００の上面図である。医療デバイス３００は、キャリア３１０と因子３４０とを含む。キャリア３１０は、表面組織の上に設置されるかまたは表面組織に接着されるように構成される。該表面組織は、皮膚などの患者の表面組織または心臓の表面組織であり得る。   FIG. 3a is a top view of a medical device 300 according to another embodiment of the present invention. The medical device 300 includes a carrier 310 and an agent 340. The carrier 310 is configured to be placed on or adhered to the surface tissue. The surface tissue may be patient surface tissue, such as skin, or heart surface tissue.

例示された実施形態において、キャリア３１０は、表面組織に接着されるように構成される材料３３０を含む。例えば、材料３３０は、グルー（ｇｌｕｅ）などの接着剤であり得る。デバイス３００の底面図は図３ｂに示される。図３ｂに示されるように、この実施形態において、材料３３０は、キャリア３１０の外周に沿って配置される。他の実施形態において、材料は、キャリアの他の位置に配置される。   In the illustrated embodiment, the carrier 310 includes a material 330 that is configured to adhere to the surface tissue. For example, the material 330 can be an adhesive such as a glue. A bottom view of device 300 is shown in FIG. 3b. As shown in FIG. 3 b, in this embodiment, the material 330 is disposed along the outer periphery of the carrier 310. In other embodiments, the material is placed at other locations on the carrier.

例示された実施形態において、因子３４０は、キャリア３１０の下側表面に結合される。従って、一旦因子３４０がキャリア３１０から解放されると、因子３４０は組織と接触し得、かつ／または組織に浸透する。他の実施形態において、キャリアは、因子が組織と接触し得、かつ／または組織に浸透し得るように、因子を解放するように構成される。線３ｃに沿ってとられる図３ｂの医療デバイス３００の断面図が、図３ｃに示される。図３ｃは、因子３４０に関連し、かつ材料３３０に関連するキャリア３１０を例示する。   In the illustrated embodiment, the factor 340 is coupled to the lower surface of the carrier 310. Thus, once the factor 340 is released from the carrier 310, the factor 340 can contact and / or penetrate tissue. In other embodiments, the carrier is configured to release the factor so that the factor can contact and / or penetrate tissue. A cross-sectional view of the medical device 300 of FIG. 3b taken along line 3c is shown in FIG. 3c. FIG. 3 c illustrates the carrier 310 associated with the factor 340 and associated with the material 330.

図４ａは、本発明の別の実施形態に従う医療デバイス４００の斜視図である。医療デバイス４００は、キャリア４１０とキャリア４１０に解放可能に結合される因子４２０とを含む。   FIG. 4a is a perspective view of a medical device 400 according to another embodiment of the present invention. The medical device 400 includes a carrier 410 and an agent 420 that is releasably coupled to the carrier 410.

別の実施形態において、因子は、表面組織に接着されるように構成される材料を含む。さらに別の実施形態において、表面組織に接着するように構成される材料は、因子を含む。   In another embodiment, the factor comprises a material configured to adhere to the surface tissue. In yet another embodiment, the material configured to adhere to the surface tissue includes a factor.

例示された実施形態において、キャリア４１０は、球体または微小球体である。キャリア４１０は、患者の体内に設置される医療デバイス４００に応答して分解するように構成される。因子４２０は、キャリア４１０が分解するとキャリア４１０から解放される。   In the illustrated embodiment, the carrier 410 is a sphere or a microsphere. The carrier 410 is configured to disassemble in response to the medical device 400 installed in the patient's body. The factor 420 is released from the carrier 410 when the carrier 410 is disassembled.

図４ｂは、図４ａにおいて線４ｂ−４ｂに沿ってとられる医療デバイス４００の断面図である。該断面図は、キャリア４１０内に因子４２０を示す。図４ｂは顆粒として因子４２０を示すが、因子４２０が顆粒である必要はない。例えば、代替の実施形態において、因子は、微小球体の内部を満たす固体、半固体、または液体である。   4b is a cross-sectional view of the medical device 400 taken along line 4b-4b in FIG. 4a. The cross-sectional view shows the factor 420 within the carrier 410. Although FIG. 4b shows factor 420 as a granule, factor 420 need not be a granule. For example, in alternative embodiments, the factor is a solid, semi-solid, or liquid that fills the interior of the microsphere.

図５ａは、本発明の別の実施形態に従う医療デバイス５００の斜視図である。医療デバイス５００は、キャリア５１０とキャリア５１０に解放可能に結合された因子５２０とを含む。   FIG. 5a is a perspective view of a medical device 500 according to another embodiment of the present invention. The medical device 500 includes a carrier 510 and an agent 520 releasably coupled to the carrier 510.

この実施形態において、キャリア５１０は、患者の体に移植されるように構成される。例えば、一実施形態において、キャリアは移植可能なプラグである。図５ｂは、図５ａにおいて線５ｂ−５ｂに沿ってとられる医療デバイス５００の断面図である。この実施形態において、因子５２０は、キャリア５１０の外側表面に結合される。   In this embodiment, the carrier 510 is configured to be implanted into the patient's body. For example, in one embodiment, the carrier is an implantable plug. FIG. 5b is a cross-sectional view of medical device 500 taken along line 5b-5b in FIG. 5a. In this embodiment, factor 520 is coupled to the outer surface of carrier 510.

図６ａは、本発明の別の実施形態に従う医療デバイス６００の斜視図である。医療デバイス６００は、キャリア６１０と因子６２０とを含む。図６ｂは、図６ａにおいて線６ｂ−６ｂに沿ってとられる医療デバイス６００の断面図である。この実施形態において、キャリア６１０は、キャリア６１０の外側表面に結合される因子６２０を有する固体の管状の構造である。   FIG. 6a is a perspective view of a medical device 600 according to another embodiment of the present invention. The medical device 600 includes a carrier 610 and an agent 620. 6b is a cross-sectional view of the medical device 600 taken along line 6b-6b in FIG. 6a. In this embodiment, the carrier 610 is a solid tubular structure having an agent 620 that is coupled to the outer surface of the carrier 610.

例示される医療デバイス５００および６００は、特定の形状を有するように医療デバイスを例示するが、医療デバイスがそのように形作られることは必ずしも必要ではない。他の実施形態において、医療デバイスは様々な形状を有し得る。   The illustrated medical devices 500 and 600 illustrate the medical device as having a particular shape, but it is not necessary for the medical device to be so shaped. In other embodiments, the medical device can have various shapes.

本発明の別の実施形態において、医療デバイスは、キャリアとキャリアに解放可能に結合される因子とを有する。この実施形態において、キャリアは、凝固噴霧溶液（ｓｏｌｉｄｉｆｙｉｎｇ ｓｐｒａｙ ｓｏｌｕｔｉｏｎ）などの、患者の体内への配置に応答して凝固するように構成される液体である。因子はキャリア内に配置される。そのような実施形態において、キャリアは、溶解または分解されて、因子を患者の体内に送達するように構成される。一実施形態において、キャリアは、心臓組織の中に噴霧または注入されるように構成される液体である。   In another embodiment of the invention, the medical device has a carrier and an agent releasably coupled to the carrier. In this embodiment, the carrier is a liquid configured to solidify in response to placement in the patient's body, such as a solidifying spray solution. The factor is placed in the carrier. In such embodiments, the carrier is configured to be dissolved or degraded to deliver the factor into the patient's body. In one embodiment, the carrier is a liquid configured to be sprayed or injected into the heart tissue.

さらに別の実施形態において、医療デバイスは、患者の体内の中に注入され得る注入可能なゲルまたは注入可能な糊を含む。   In yet another embodiment, the medical device includes an injectable gel or injectable glue that can be injected into the patient's body.

本発明は詳細にかつ本発明の特定の実施形態に関して記述されてきたが、本発明において様々な変更および修正が、本発明の精神および範囲から逸脱することなく、なされ得ることは当業者にとって明らかである。従って、本発明の修正および変形が添付の請求項およびそれらの均等物の範囲内であれば、本発明は本発明の修正および変形を含むことが意図される。   Although the invention has been described in detail and with reference to specific embodiments of the invention, it will be apparent to those skilled in the art that various changes and modifications can be made in the invention without departing from the spirit and scope of the invention. It is. Thus, it is intended that the present invention include modifications and variations of this invention provided they come within the scope of the appended claims and their equivalents.

図１は、本発明の実施形態に従う医療デバイスの略図である。FIG. 1 is a schematic diagram of a medical device according to an embodiment of the present invention. 図２ａは、本発明の別の実施形態に従う医療デバイスの斜視図である。FIG. 2a is a perspective view of a medical device according to another embodiment of the present invention. 図２ｂは、線２ｂ−２ｂに沿ってとられる図２ａの医療デバイスの断面図である。2b is a cross-sectional view of the medical device of FIG. 2a taken along line 2b-2b. 図２ｃは、本発明の別の実施形態に従う医療デバイスの断面図である。FIG. 2c is a cross-sectional view of a medical device according to another embodiment of the present invention. 図３ａは、本発明の別の実施形態に従う医療デバイスの上面図である。FIG. 3a is a top view of a medical device according to another embodiment of the present invention. 図３ｂは、図３ａの医療デバイスの底面図である。3b is a bottom view of the medical device of FIG. 3a. 図３ｃは、線３ｃ−３ｃに沿ってとられる図３ｂの医療デバイスの断面図である。3c is a cross-sectional view of the medical device of FIG. 3b taken along line 3c-3c. 図４ａは、本発明の別の実施形態に従う医療デバイスの斜視図である。FIG. 4a is a perspective view of a medical device according to another embodiment of the present invention. 図４ｂは、線４ｂ−４ｂに沿ってとられる図４ａの医療デバイスの断面図である。4b is a cross-sectional view of the medical device of FIG. 4a taken along line 4b-4b. 図５ａは、本発明の別の実施形態に従う医療デバイスの斜視図である。FIG. 5a is a perspective view of a medical device according to another embodiment of the present invention. 図５ｂは、線５ｂ−５ｂに沿ってとられる図５ａの医療デバイスの断面図である。FIG. 5b is a cross-sectional view of the medical device of FIG. 5a taken along line 5b-5b. 図６ａは、本発明の別の実施形態に従う医療デバイスの斜視図である。FIG. 6a is a perspective view of a medical device according to another embodiment of the present invention. 図６ｂは、線６ｂ−６ｂに沿ってとられる図６ａの医療デバイスの断面図である。6b is a cross-sectional view of the medical device of FIG. 6a taken along line 6b-6b.

Claims (28)

心筋梗塞後の心筋のスカフォールドの劣化を防ぐために、心臓組織の炎症を制御するように処方された因子と、
該因子が解放可能に結合されたキャリアであって、該キャリアは、該因子によって治療されるべき該心臓組織に作用可能な近さに配置されるように構成される、キャリアと
を備えている、医療デバイス。 Factors prescribed to control inflammation of heart tissue to prevent deterioration of the myocardial scaffold after myocardial infarction; and
A carrier to which the agent is releasably coupled, the carrier configured to be placed in close proximity to the heart tissue to be treated by the agent , Medical devices. 前記キャリアはステントである、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a stent. 前記キャリアは第１の端部および第２の端部を有し、該キャリアは該第１の端部から該第２の端部まで延びる内腔を規定する、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier has a first end and a second end, the carrier defining a lumen extending from the first end to the second end. 前記キャリアはパッチである、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a patch. 前記キャリアは、表面組織に接着するように構成され、そして該表面組織を介して前記因子を解放するように構成される材料を含む、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier comprises a material configured to adhere to surface tissue and configured to release the factor through the surface tissue. 前記キャリアは、該キャリアを患者の体に付着させるように構成される接着要素を含み、該キャリアは前記心臓組織を介して前記因子を解放するように構成される、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier includes an adhesive element configured to attach the carrier to a patient's body, the carrier configured to release the factor through the heart tissue. . 前記キャリアは、微小球体である、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a microsphere. 前記キャリアは、患者の体内に設置される前記医療デバイスに応答して分解するように構成される球体を含み、前記因子は、該球体が分解すると該キャリアから解放されるように構成される、請求項１に記載のデバイス。   The carrier includes a sphere configured to disassemble in response to the medical device placed in a patient's body, and the factor is configured to be released from the carrier when the sphere disintegrates. The device of claim 1. 前記キャリアは凝固噴霧溶液である、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a coagulated spray solution. 前記キャリアは、患者の体内への配置されることに応答して凝固するように構成される液体である、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a liquid configured to solidify in response to being placed in a patient's body. 前記キャリアは注入可能なゲルである、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is an injectable gel. 前記キャリアは注入可能な糊である、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is an injectable glue. 前記キャリアは、患者の体内に注入されるように構成される半固体材料である、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a semi-solid material configured to be injected into a patient's body. 前記キャリアは移植可能なプラグである、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is an implantable plug. 前記キャリアは、患者の体内に移植されるように構成される一塊の材料である、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is a mass of material configured to be implanted in a patient's body. 前記キャリアは、制御される方法で前記因子を解放するように構成される、請求項１に記載のデバイス。   The device of claim 1, wherein the carrier is configured to release the factor in a controlled manner. 前記因子は、制御される方法で前記キャリアから解放されるように構成される、請求項１に記載のデバイス。   The device of claim 1, wherein the factor is configured to be released from the carrier in a controlled manner. 前記因子は、第１の期間に第１の速度、および該第１の期間とは異なる第２の期間に該第１の速度とは異なる第２の速度で、前記キャリアから解放されるように構成される、請求項１に記載のデバイス。   The factor is released from the carrier at a first rate during a first period and a second rate different from the first rate during a second period different from the first period. The device of claim 1, wherein the device is configured. 前記因子は、間葉幹細胞、徐放形態のアスピリン、インターロイキン、ヘムオキシゲナーゼ、コルチコステロイド、タクロリムス、およびシクロスポリンからなる群のうちの少なくとも１つを含む、請求項１に記載のデバイス。   The device of claim 1, wherein the factor comprises at least one of the group consisting of mesenchymal stem cells, sustained release form of aspirin, interleukin, heme oxygenase, corticosteroid, tacrolimus, and cyclosporine. 前記因子は、ＮＳＡＩＤ、ピラゾロン、フェナム酸、ジフルニサル、酢酸誘導体、プロピオン酸誘導体、オキシカム、メフェナム酸、ポンステール、メクロフェナム酸塩、メクロメン、フェニルブタゾン、ブタゾリジン、ジフルニサル、ドロビッド、ジクロフェナク、ボルタレン、インドメタシン、インドシン、スリンダク、クリノリル、エトドラク、ロジン、ケトロラク、トラドール、ナブメトン、レラフェン、トルメチン、トレクチン、イブプロフェン、モトリン、フェノプロフェン、ナルフォン、フルビプロフィン、アンセイド、カルプロフェン、リマダイル、ケトプロフェン、オルヂス、ナプロキセン、アナプロックス、ナプロシン、ピロキシカム、およびフェルデンからなる群のうちの少なくとも１つを含む、請求項１に記載のデバイス。   The factors include NSAID, pyrazolone, fenamic acid, diflunisal, acetic acid derivative, propionic acid derivative, oxicam, mefenamic acid, ponster, meclofenamic acid, meclomen, phenylbutazone, butazolidine, diflunisal, drobid, diclofenac, voltaren, indomethacin, indosin , Sulindac, Crinolyl, Etodolac, Rosin, Ketorolac, Tradol, Nabumeton, Lerafen, Tolmetine, Trectin, Ibuprofen, Motrin, Fenoprofen, Narfone, Flubiprofin, Ansaid, Carprofen, Rimadil, Ketoprofen, Ordiz, Naproxen, Anaprox, 2. The deion of claim 1, comprising at least one of the group consisting of naprosin, piroxicam, and ferden. Chair. 瘢痕組織の形成を防ぐために、生物学的組織の炎症を制御するように処方された因子と、
該因子が解放可能に結合されたキャリアであって、該キャリアは、該因子によって治療されるべき該生物学的組織に作用可能な近さに配置されるように構成される、キャリアと
を備えている、医療デバイス。 Factors prescribed to control inflammation of biological tissue to prevent the formation of scar tissue;
A carrier to which the agent is releasably bound, the carrier configured to be placed in close proximity to the biological tissue to be treated by the agent. A medical device. 前記キャリアはステントである、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is a stent. 前記キャリアはパッチである、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is a patch. 前記キャリアは微小球体である、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is a microsphere. 前記キャリアは凝固噴霧溶液である、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is a coagulated spray solution. 前記キャリアは注入可能なゲルである、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is an injectable gel. 前記キャリアは注入可能な糊である、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is an injectable glue. 前記キャリアは移植可能なプラグである、請求項２１に記載のデバイス。   The device of claim 21, wherein the carrier is an implantable plug.
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